Individual
DR. ALICIA ANNE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
350 W WOODROW WILSON AVE, JACKSON MEDICAL MALL, SUITE 3516, JACKSON, MS 39213-7681
(601) 987-5566
(601) 987-5595
Mailing address
5518 PINE LANE DR, JACKSON, MS 39211-4018
(601) 899-9200
(601) 899-9200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3196-01
MS
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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